Breastfeeding Medicine

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A tribute to Audrey Naylor

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As the ABM Founders Representative to the ABM Board, I wish to reflect on the personal and professional impact of one of our ABM Founders, Audrey Naylor, DrPH, MPH, MD, who recently passed away (6/23/2016).  Her personality and actions provided an example for all of us to be successful contributors to lactation management and the future success of the ABM. Audrey, as early as the late ‘70’s, recognized the “cascade” effect of training and teaching the teachers, i.e. she was a cofounder and CEO of Wellstart International. An example of her success with Wellstart is the internet breastfeeding training modules which are free online at www.wellstart.org . She focused, as each of us must do now, on educating learners to pass their knowledge on to the next generation of providers. Her model for education recognized that optimal breastfeeding management requires a coordinated multidisciplinary team; physicians practicing alone cannot be successful. This passion was brought to focus in her role as an early and prominent proponent of the Baby Friendly initiative. Audrey believed passionately in the world community. Her voice and passion about breastfeeding has been heard and recognized at UNICEF and the WHO. As a Founder of the ABM, Audrey was a very active proponent for the ABM to be an international organization. While her advocacy has been largely successful, we must continue to act as an international organization and create better ways for us to utilize the unique strengths of every culture/country.

Lastly, Audrey Naylor had the courage, strength of personality, academic credibility, and national/international reputation to be a vocal and active “Champion” of breastfeeding on the national and international stage. While few of us will attain her stellar level of recognition and achievement, each member of the ABM needs to be a vocal and active “Champion” for breastfeeding within our smaller communities. We need to be agents for constructive and positive change, as Audrey always was.

Audrey, thank you for your example and your friendship. We will always remember your professional training and performances as “The Red Nosed Clown” at our annual meetings.

Edward Newton, MD

Ed Newton, MD, FABM is a maternal-fetal medicine sub specialist and a founder of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by newtoned

August 7, 2016 at 10:30 am

Posted in Uncategorized

“Lactivism” and breastfeeding backlash: A second look

with 77 comments

It’s become routine: a big anti-breastfeeding piece comes out in a major publication like the New York Times, or The Atlantic or Time. A mom complains how the benefits of breastfeeding are overrated, how breastfeeding is being forced on people, how moms are feeling shamed into breastfeeding or risk being bad mothers.

Let’s listen to these moms for a minute. Regardless of what we breastfeeding people are actually saying, this is what moms are hearing. We need to ask ourselves, why do they hear this message?

Here’s why: Moms experience the “lactivist.” To the uninitiated, the term “lactivist” equals zealot. Someone who believes that breastfeeding is the answer for every mom in every situation, someone who is inflexible, incapable of listening to a mom’s individual needs and desires.

Any woman who’s just had a baby would probably see a “lactivist” as The Enemy. Imaging yourself as that new mom. You are not thinking the “lactivist” is a savior in a white cape who’s going to defend you from evil hospitals who want to give your baby formula. She’s someone who’s going to push everyone out of the way and make you breastfeed, regardless of your own trials and tribulations, your pain, your exhaustion. She’d not there to help you. She’s there to advance her own agenda of world breastfeeding hegemony.

And, if a mom doesn’t actually encounter a self-described lactivist, she might see the effects. All it takes is a journalist-mom who hears one resentful nurse say “we’re not allowed to teach formula feeding,” and you’ve generated enough anger for a full page New York Times op-ed. This journalist then misrepresents the scientific evidence for the entire world to prove her point that the so-called “Breastfeeding Nazis” are out to get you, and it’s just not worth it, because breastfeeding’s not even all that good for your baby anyway.

We must be careful with our rhetoric, and treat every single mom with compassion and understanding. We must take care in how we train our staff and how that staff communicates to patients. Breastfeeding people all know that it’s required to teach moms how to formula feed, and staff must feel inside that this is valuable information for many moms.

It only takes one “lactivist” to piss off a journalist. You never know who might turn around and write that next full page op-ed for the New York Times.

So please, let’s stop using the word “lactivist.” Better yet, let’s replace zealotry with compassion and understanding, and meet every mom where she is. And if we see zealotry in our colleagues, let’s gently remind them that this may be how we got to that Time magazine cover and New York Times op-ed. That is the only way we will stop this negative press.

Melissa Bartick, MD, MSc is an internist at Cambridge Health Alliance and Assistant Professor at Harvard Medical School. 

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by Melissa Bartick, MD, MSc

October 21, 2015 at 1:15 pm

Posted in Uncategorized

WBW 2015: Women and Work, Let’s Make it WORK

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Whether you celebrate World Breastfeeding Week (WBW) or National Breastfeeding Month, and whether you choose the first week in August or October, the time to be launching your efforts is NOW!

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The World Alliance for Breastfeeding Action (WABA) is perhaps best known for its global sponsorship of World Breastfeeding Week (WBW), but it is much more: WABA is a global network of individuals and organizations concerned with the protection, promotion & support of breastfeeding worldwide. WABA’s actions are based on the Innocenti Declaration, the Ten Links for Nurturing the Future and the Global Strategy for Infant and Young Child Feeding. WABA is in consultative status with UNICEF and is also an NGO in Special Consultative Status with the Economic and Social Council of the United Nations (ECOSOC). Its Core Partners include ABM, IBFAN, ILCA, LLLI and Wellstart International, with a shared mission: “To protect, promote and support breastfeeding worldwide, in the framework of the Innocenti Declarations (1990 and 2005) and the Global Strategy for Infant and Young Child Feeding, through networking and facilitating collaborative efforts in social mobilisation, advocacy, information dissemination and capacity building.”
World Breastfeeding Week this year occurs on the 25th anniversary of the Innocenti Declaration, signed by more than 30 countries (including the US) that stated the countries’ intention to implement the following by 1995:

  • Create a national multidisciplinary authority for government support and oversight of breastfeeding
  • Ensure all hospitals practice the Ten Steps for Breastfeeding
  • Implement the International Code of Marketing and subsequent WHA resolutions
  • And, last but by no means least, ensure maternity protection, including the ILO guidance of at least 14 weeks paid maternity leave and workplace accommodation.

This year’s theme supports the Innocenti Declaration as well as WABA’s goal to create an enabling environment for mothers and families worldwide to decide to optimally breastfeed and to succeed in that goal Breastfeeding and Work – Let’s make it work! This theme highlights the importance of ongoing support for necessary leave and workplace support.

Now is the time to inspire, empower and educate while we support, protect and promote breastfeeding. Get ready to act now in support of the theme for World Breastfeeding Week 2015. Please visit worldbreastfeedingweek.org for information on the theme, materials you can download, a photo contest and WBW 2015 Pledge forms to tell the world about your efforts.

Miriam H Labbok, MD, MPH, IBCLC, FABM, FILCA is Professor and Director of the Carolina Global Breastfeeding Institute in the Department of Maternal and Child Health at the UNC Gillings School of Global School Public Health. She is a Founder, past president and member of the board of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by labbok

August 2, 2015 at 6:51 pm

Posted in Uncategorized

How often does breastfeeding come undone?

with 45 comments

One afternoon in my lactation clinic, I saw two mothers who came to see me because they couldn’t make milk. One was pregnant with her second child, and the other was considering a third pregnancy. Each described how they had looked forward to breastfeeding, taken classes, put their babies skin-to-skin and birth, offered the breast on demand, and then waited, for days, and then weeks, for milk that never came in. As the second mother came to the end of her story, she said, “No one ever told me this could happen. Have you ever heard of a woman not being able to make milk?”

“Yes,” I said. “There’s one in the very next room.”

The dogma is that inability to breastfeed is rare – “like unicorns,” one blogger wrote – but I was seeing an awful lot of unicorns in my clinic. I couldn’t help but wonder – how often does breastfeeding come undone? Read the rest of this entry »

Written by astuebe

March 27, 2014 at 4:23 pm

ABM Executive Committee urges AAP to discontinue formula marketing relationship

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Thomas K. McInerny, President, American Academy of Pediatrics

Dr. McInerny:

We are writing on behalf of the Academy of Breastfeeding Medicine (ABM), a multispecialty worldwide organization of physicians dedicated to the support, promotion and protection of breastfeeding and the education of our fellow physicians, to urge the American Academy of Pediatrics to discontinue its participation in infant formula marketing in maternity hospitals and pediatric practices.

It has come to our attention that the AAP has contracted with Mead Johnson to provide AAP-branded materials as part of the formula manufacturer’s maternity discharge pack. Such discharge packs have been shown in randomized controlled trials to reduce breastfeeding duration and exclusivity. Based on this Level I evidence, UNICEF, the World Health Organization, the Baby-Friendly Hospital Initiative, the American Public Health Association, the Academy of Breastfeeding Medicine, the Centers for Disease Control and Prevention, and the United States Surgeon General oppose infant formula marketing in health care settings. Concern about these harmful effects of formula marketing has led two-thirds of America’s 45 top hospitals to discontinue formula advertising in their maternity wards. It is therefore deeply troubling that the AAP has contracted with Mead Johnson to support this practice.

The AAP’s decision to contract with Mead Johnson also violates multiple AAP policy statements. Distribution of discharge packs has been identified as detrimental to exclusivity and duration of breastfeeding in the AAPs Policy Statement on Breastfeeding and the Use of Human Milk.  In its resolution on Divesting from Formula Marketing in Pediatric Care, the Academy advises pediatricians not to provide formula marketing materials to parents of newborns and infants. Both the AAP’s Sample Hospital Breastfeeding Policy for Newborns and  ABM’s Model Breastfeeding Policy prohibit provision of formula marketing materials to mothers.

AAP participation in formula marketing undermines consensus medical recommendations for exclusive breastfeeding for the first six months of life and is harmful to the health of mothers and infants. We urge the AAP to discontinue this relationship with Mead Johnson. We further urge the AAP leadership to implement a formal policy prohibiting Academy participation in direct-to-consumer marketing of formula or formula company materials.

Thank you for your consideration.

Sincerely,
Dr. Wendy Brodribb,  President (Family Physician)

Dr. Arthur Eidelman,  Immediate Past President (Pediatrician)

Dr. Julie Taylor,  President-Elect (Family Physician)

Dr. Tim Tobolic, Treasurer (Family Physician)

Dr. Kathie Marinelli,  Secretary (Pediatrician)

cc. Dr. Kinga Szucs, ABM representative to SoB AAP

Written by bfmed

December 26, 2013 at 11:26 am

Posted in Uncategorized

ABM Gold Member Profile: Anne M. Montgomery, MD, FABM

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Anne Montgomery, MD

Anne Montgomery, MD, FABM
Associate Director
Family Medicine Residency
Eisenhower Medical Center

ABM: Why did you become a member of ABM?

Montgomery: I was very involved in breastfeeding support and wanted to be part of a group of similar physicians.

ABM: What is ABM‘s greatest strength?

MontgomeryThe diversity and expertise of our members.

ABM: What inspires you to promote, protect and support breastfeeding?

Montgomery:  Like many people, I was a “mainstream breastfeeding supporter” til I had my son; breastfeeding him exclusively for 5.5 months then continuing for 4.5 years “radicalized” me. I recognized that not not everyone had the tenacity/stubbornness to overcome all the barriers. As a physician to mothers and babies, it was part of my responsibility to be sure that all babies had the opportunity to be breastfed and that all mothers were supported in their feeding choices.

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

MontgomeryJoin ABM! Don’t be afraid to attend courses aimed at nurses and lactation consultants if that is all that is available in your area.

ABM: What accomplishment are you most proud of in your career?

Montgomery: I achieved full professor academic rank in my late 40’s and have taught many residents and students about family medicine including breastfeeding.

ABM: What is a current challenge for you in your work?

Montgomery: Starting a new job soon, I don’t know what to expect yet! A brand new family medicine residency program should be interesting.

ABM: What can ABM offer physicians worldwide?

Montgomery: A chance to network with other like-minded physicians, good breastfeeding education, and support for their work assisting mothers and babies.

Thank you, Dr. Montgomery.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each month.

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

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Written by bfmed

August 28, 2013 at 9:11 am

ABM Gold Member Profile: Lori Feldman-Winter, MD, MPH, FABM

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Dr. Lori Feldman-Winter

Lori Feldman-Winter, MD, MPH, FABM
Professor of Pediatrics
Children’s Regional Hospital at Cooper, Cooper Medical School of Rowan University

ABM: Why did you become a member of ABM?

Feldman-Winter: I wanted opportunities to network with colleagues that had a shared interest and learn from others work.

ABM: What is ABM‘s greatest strength?

Feldman-WinterThe members are definitely what makes this organization special. Each member makes their own unique contributions and we all learn from each other.

ABM: What inspires you to promote, protect and support breastfeeding?

Feldman-Winter:  For too many years breastfeeding fell outside the realm of mainstream medicine and physicians were unprepared to support mothers decisions to breastfeed. Through organizations such as ABM physicians are much more knowledgeable and skillful in their support, but we still have a long way to go!

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

Feldman-WinterFirst take courses, especially those geared for physicians such as the WEPNTKAB course. Then join organizations such as the ABM to gain a better understanding of the field from the physicians’ perspective. Then get involved, there are so many opportunities to make a real difference.

ABM: What accomplishment are you most proud of in your career?

Feldman-Winter: I have dedicated a large part of my career in breastfeeding medicine to physician education. Being part of the inaugural group of FABM’s is one of the highlights of my career.

ABM: What is a current challenge for you in your work?

Feldman-Winter: In my current work as a consultant to NICHQ Best Fed Beginnings Project, my biggest challenge is to convince physicians all over the country that they need to make changes, including getting the required education, to help their hospitals achieve Baby-Friendly designation. The resistance to change is sometimes overwhelming. Somehow we need to convince all physicians to acknowledge that we all have much to learn about breastfeeding, and that it is a vital component of healthcare.

ABM: What can ABM offer physicians worldwide?

Feldman-Winter: The clinical protocols are helpful to set a global agenda for optimal evidence based care.

Thank you, Dr. Feldman-Winter.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each week.

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

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